Friday, March 20, 2009

FVA

The other day I went to a school to observe a little girl and give her a function vision screening as part of her educational evaluation. The child was in a pre-K class. I will call her "BabyGirl" here. (So cute!)

This happens to be the same school where Mr. Hebrews 13:1-3 is enrolled. [By the way, that little rascal has not returned to school YET!]

The kids were coming from breakfast and I introduced my self to the teacher. She seemed delighted to see me. During the time I was there I discovered that she was a truly dedicated teacher, thus to have someone come to help one of her babies---well, certainly she would be happy to meet them! I can appreciate that as I have been the same way when I had a classroom of children--or students under any situation.

She pointed out the child to me at the rear of the line--a cute baby with two little Afro-puffs on top of her head. You could tell that mom took time to make sure she was dressed neatly and that the hair was just so. The whole class was cute--full of little people about waist high! The child was very quiet and although she looked at me and gave me a half smile, she did not speak, She focused on her spot at the end of the line.

I knew that part of the morning routine was a line to the potty after breakfast so I told the teacher that I would just follow the class rather than interrupt the routine. I unpacked my vision testing equipment and my camera while the kids went to the restrooms just outside the classroom.

When some of the children began to return to the class, they found their names on a table and began to "sign in" meaning that they took another sheet of paper and attempted to copy or scribble their names on another sheet of paper before going to their seats.

BabyGirl was one of the last of the little girls to return. She happily came outside with me to have her picture taken. I heard her gasp as she covered her face from the direct morning sunlight.

"Oh my!" I said. "It is very bright out here. Let's have you face this way so that the sun is not in your face so."

Even sideways, from facing the sun she continued to squint a bit.I made a mental note as I showed her several photos on the camera's view finder to see if she could point out her own picture on the two-inch by two-inch screen. She looked at the screen but didn't point to anything.

When we went back inside, I realized why she was not interested in the camera any more. The children were gathering on the carpet at the front of the class for circle time. Each child sat on his/her name on a piece of tape on the carpet. BabyGirl was letting me know that she had to follow the routine to feel comfortable--so I let her go. I'd observe her in her routine and jump in there with questions or get something out of her while she did her usual thing.

The teacher sat at the front of the circle next to the calendar which was at eye level for little waist high beings. "What did you do at home yesterday?" she asked each child.

"I played my games and I ate my supper. Then I went to bed," said one child.

The little woman next to BabyGirl who is obviously a 44-year-old impostor, ran off a list of things she did at home the day before after she got off from work. I believe she cooked dinner for her family and righted a derailed train after leaping a skyscraper with a single bound. Her teacher grinned at her: "You're full of baloney, aren't you?"

They both chuckled and the forty-four year old laughed, "Yes ma'am, but I did eat hotdogs last night."

Then it was BabyGirl's turn. She didn't say anything. "Did you play?" the teacher asked. BabyGirl nodded.

Modeling the Amslang for "I played" the teacher slowly said, "Then say 'I played'."
That signaled the whole class to sign and say "I played!"

By this time I was on the floor behind BabyGirl. She barely shook her hands to sign "play" when Forty-four said to me, "She didn't learn to talk yet."

I smiled as I thought of one of my husband's favorite lines from the movie "Inside Man." Thank you bank robber! I'm learning so much today!"

The teacher called the children's attention to the calendar. It was another lovely little girl's turn to use the pointer for the days of the week. She chose the star pointer, which the teacher said seemed to be everyones' favorite. I was partial to the ones with the Mickey Mouse-looking white gloved fingers on the end. Those were cool. I think I will find one for myself.

The children had a rhyme and rhythm for saying the days of the week. BabyGirl moved her hands to the rhythm like the other children and smiled---but she didn't say anything. Nor were her hand movements for any Amslang for the days of the week.

I noticed, too, that as the teacher pointed to anything on the calendar, BabyGirl was not focusing on anything in that direction. Of course she knew that the teacher was in front of the class, but by the unfocused look, she was not aware of anything that was being pointed out up there. She simply was not seeing it. She was following the routine and following along with the other children as often children with low vision will do.

Then it was center time and Babygirl was to take a card with her picture on it and take it to the center where she wanted to play. Since she was a bit more comfortable with me, I followed her to the block center.


There I saw some manipulatives that looked like miniature poker chips. They were either yellow, green, red or blue. There were also some giant pegs and Legos in those colors. If she was going to confuse colors I had to give her a choice between the green blue and red objects. I pretended I wanted to play with some of the objects and asked her to help me with the red chips, then the green pegs and the blue pegs. She never confused the yellow objects as obviously they are lighter, but the others seemed always confused. As I explained to her teacher, it is difficult to tell if some of that would be cognitive or true color blindness. But when the teacher told me later that she follows directions very well it made me think. When I returned to my office, I saw my notes on her and in the email from my supervisor BabyGirl has been diagnosed as having optic nerve atrophy. Some sensitivity to light and color blindness is common with optic nerve atrophy.

The teacher asked if there was something she could be doing. I mentioned the calendar and that I was unsure bout colorblindness. I told her about allowing her to step up to certain charts rather than pint them out across the room because she was not seeing clearly beyond a few feet in front of her. Arms' length was no problem, though.

The teacher started to feel bad. "I haven't been thinking about her vision! Just handling the other things like the speech...and that she needs time to keep up--she sometimes moves very slow. I didn't even think that that poor baby..."

"No, no, no," I comforted her. "It is easy to see total blindness. Children with low vision will fool you. Not because they are trying to deceive you at this age, but they just do what the other children do and that gets them by."

I suggested I take her out for a few minutes. Iusually see if a child can take me to three places on a school campus. She gave BabyGirl the lunch envelope and told her she was picked to take it to the cafeteria. We would walk behind her and she could lead us there.
The little hands took the big envelope. Then a finger of one hand went into her mouth as if she were saying,"Hmmmm.I'm not sure bout this."
When we got outside, BabyGirl stopped and waited for guidance. She didn't seem sure of which way she should turn when she was asked. She just stood and looked back and forth between the two of us.

Finally her teacher took a few steps ahead and said," OK, where do we go from here to get to the cafeteria?"

BabyGirl stepped next to her teacher but that was a far as she was going. her teacher prompted her to walk ahead. She did so very reluctantly, looking behind her for her teacher. She did not know her way to the cafeteria without prompting. On the way back I asked her if she'd feel more comfortable holding hands with one of us adults. of course she reached for her teacher's hand.

For about a month, BabyGirl had been walking in the middle or at the end of the line using the other children to get around the school. the teacher felt so bad. "That is why there is so much confusion at the end of the day when our line meets with other lines in the building. All of the children wear the same color uniform shirts and she gets totally confused in the halls with large groups of children!"

I assured the teacher that I would have a good report written and that she would be fine. When I got back to my office, I wrote a report of my observation with my recommendations and emailed it to the appropriate pupil appraisal personnel.

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